You’ve got to hand it to Marni Soupcoff and the Canadian Constitution Foundation. Their PR team is firing on all cylinders right now in their attempts to sell Canadians on two-tier health care. One might wonder where their passionate fervour to spread the word on Brian Day’s charter challenge comes from. Is it possible that Soupcoff et al are just that committed to improving health care for Canadians? Or is it more likely that the CCF is committed to blasting their message out into the media in an attempt to drown out the real reasons for this trial?
On June 1, Brian Day will launch his charter challenge in the BC Supreme Court, alleging that the inability of Canadians to buy health care from for-profit clinics is a violation of the Charter. In preparation for the trial, Day’s team is focusing on patients who suffer while waiting for surgeries in Canada. Given the origin of the trial, it’s not surprising that Day is trying to shift the focus to patients’ experiences.
Since Day’s clinic, the Cambie Surgery Centre, opened its doors in 1996, patients have been complaining to the government about its practice of extra-billing. Finally, in 2010, the BC government launched an audit of Cambie’s billing practices. The final report, released in 2012, revealed that in roughly 30 days, Day’s clinics extra-billed patients $491,654. When the province told Cambie to stop this practice, Day responded with a charter challenge. The only thing more disconcerting than Day not facing penalties for his practice of extra-billing is the idea that he might open up Canadian health care to privatization to avoid doing so.
To understand what Day is proposing, imagine that you are driving on a highway that has three lanes going in one direction. The lanes have moderately heavy traffic. Day's solution to improving congestion on the highway would be to take one of the three lanes and make it a priority lane. With this new system, people can pay a fee to access the priority lane. But the fee is costly, so not many people get out of the other two lanes. As a result, the highway becomes very speedy for the handful of people in the private lane but congestion gets worse in the other two lanes. Resources that previously were available to everyone are now earmarked for a select group meaning that congestion and travel time actually gets worse for the majority of drivers.
That is precisely what happens when we allow a for-profit dimension in health care. Resources that were previously available for the public system get siphoned off to a parallel, private system that provides priority care to the few people who can afford it. Health researcher Colleen Flood reports that, in New Zealand, the creation of a parallel, private system has resulted in specialists spending only 48.9 per cent of their time working in public hospitals. This means that wait times for the majority of patients get longer as specialists divert their time away from the public system.
Day’s team likes to assure Canadians that they would be able to get faster care in this new system but the reality is that few of us would be able to pay the fees. The Calgary-based for-profit clinic, Helios, offers a great example of what type of care would become more common if Day wins. In order to see a doctor at Helios, patients are required to pay a $10,000 membership fee annually. I don’t know many people who have an extra $10,000 that they can hand over just to get in the clinic door.
You would be hard pressed to find a doctor in Canada who isn’t frustrated by the limitations of our health care system. Are there gaps in care? Absolutely. Do we need to address wait times? Certainly. But what Day is proposing, and what the CCF is supporting, will only break the system more. Canadian Doctors for Medicare are acting as interveners in Day’s trial because we are passionately committed to improving our health care system and we know from international research, and from Canada’s early experiences with for-profit care, that adding a for-profit element to our health care system will mean longer waits for most and higher costs for all.
It’s time to start focusing on real solutions to the challenges facing our health care system.
To learn more about solutions that can improve the accessibility, quality, and sustainability of our health care system, Canadian Doctors for Medicare hosts a discussion on twitter every Monday afternoon to highlight the innovations available to improve the public health care system. It’s time to have a real conversation about improving health care and reducing wait times. While there are many exciting solutions to the problems facing our health care system, none of them involve Brian Day being able to bill Canadians an extra $500,000 every month.
Dr. Monika Dutt is the chair of Canadian Doctors for Medicare and a practising public health and family physician in Cape Breton, Nova Scotia.